Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | 0432410 | KS |
N | 2080P0210X | Pediatric Nephrologist | 2007007792 | MO |
N | 2080P0210X | Pediatric Nephrologist | 35.080288 | OH |
Y | 2080P0210X | Pediatric Nephrologist | MD54527 | TN |
NPI | 1902838592 |
---|---|
Provider Name | Rene G Vandevoorde III |
First Address | Nashville, TN 37232-5100 |
Second Address | Nashville, TN 37232-5100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 15/10/2020 |